Herpesvirus 6 Infection Treatment & Management

  • Author: Ruchir Agrawal, MD; Chief Editor: Russell W Steele, MD   more...
 
Updated: Mar 21, 2012
 

Medical Care

Provide supportive therapy for patients with symptomatic human herpesvirus 6 (HHV-6) infection.

Ensure adequate fluid balance.

Administer acetaminophen or ibuprofen to patients with high-grade fever, patients who are uncomfortable, or patients who have a previous history of febrile seizures.

Treatment of individuals with acute human herpesvirus 6 is under investigation. Some experts recommend ganciclovir and foscarnet in severe incidents.

Proceed to Medication
 
 
Contributor Information and Disclosures
Author

Ruchir Agrawal, MD  Chief, Allergy and Immunology, Aurora Sheboygan Clinic

Ruchir Agrawal, MD, is a member of the following medical societies: American Academy of Allergy Asthma and Immunology, American Academy of Pediatrics, American College of Allergy, Asthma and Immunology, and American Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Leonard R Krilov, MD  Chief of Pediatric Infectious Diseases and International Adoption, Vice Chair, Department of Pediatrics, Professor of Pediatrics, Winthrop University Hospital

Leonard R Krilov, MD is a member of the following medical societies: American Academy of Pediatrics, American Pediatric Society, Infectious Diseases Society of America, Pediatric Infectious Diseases Society, and Society for Pediatric Research

Disclosure: Medimmune Grant/research funds Cliinical trials; Medimmune Honoraria Speaking and teaching; Medimmune Consulting fee Consulting

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Larry I Lutwick, MD  Professor of Medicine, State University of New York Downstate Medical School; Director, Infectious Diseases, Veterans Affairs New York Harbor Health Care System, Brooklyn Campus

Larry I Lutwick, MD is a member of the following medical societies: American College of Physicians and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Robert W Tolan Jr, MD  Chief, Division of Allergy, Immunology and Infectious Diseases, The Children's Hospital at Saint Peter's University Hospital; Clinical Associate Professor of Pediatrics, Drexel University College of Medicine

Robert W Tolan Jr, MD is a member of the following medical societies: American Academy of Pediatrics, American Medical Association, American Society for Microbiology, American Society of Tropical Medicine and Hygiene, Infectious Diseases Society of America, Pediatric Infectious Diseases Society, Phi Beta Kappa, and Physicians for Social Responsibility

Disclosure: Novartis Honoraria Speaking and teaching

Chief Editor

Russell W Steele, MD  Head, Division of Pediatric Infectious Diseases, Ochsner Children's Health Center; Clinical Professor, Department of Pediatrics, Tulane University School of Medicine

Russell W Steele, MD is a member of the following medical societies: American Academy of Pediatrics, American Association of Immunologists, American Pediatric Society, American Society for Microbiology, Infectious Diseases Society of America, Louisiana State Medical Society, Pediatric Infectious Diseases Society, Society for Pediatric Research, and Southern Medical Association

Disclosure: Nothing to disclose.

Additional Contributors

The authors and editors of eMedicine gratefully acknowledge the contributions of previous author Sue Jue, MD, to the development and writing of this article.

References

  1. Harris RC. Long-term effects of human herpesvirus 6 infection. Pediatrics. Sep 2008;122(3):679. [Medline].

  2. Voumvourakis KI, Kitsos DK, Tsiodras S, Petrikkos G, Stamboulis E. Human herpesvirus 6 infection as a trigger of multiple sclerosis. Mayo Clin Proc. Nov 2010;85(11):1023-30. [Medline]. [Full Text].

  3. Yamanishi K, Okuno T, Shiraki K, et al. Identification of human herpesvirus-6 as a causal agent for exanthem subitum. Lancet. May 14 1988;1(8594):1065-7. [Medline].

  4. Murakami Y, Tanimoto K, Fujiwara H, An J, Suemori K, Ochi T, et al. Human herpesvirus 6 infection impairs Toll-like receptor signaling. Virol J. May 10 2010;7:91. [Medline]. [Full Text].

  5. Chang YL, Parker ME, Nuovo G, Miller JB. Human herpesvirus 6-related fulminant myocarditis and hepatitis in an immunocompetent adult with fatal outcome. Hum Pathol. Jan 12 2009;[Medline].

  6. Prezioso PJ, Cangiarella J, Lee M, et al. Fatal disseminated infection with human herpesvirus-6. J Pediatr. Jun 1992;120(6):921-3. [Medline].

  7. Hoang MP, Ross KF, Dawson DB, et al. Human herpesvirus-6 and sudden death in infancy: report of a case and review of the literature. J Forensic Sci. Mar 1999;44(2):432-7. [Medline].

  8. Laina I, Syriopoulou VP, Daikos GL, Roma ES, Papageorgiou F, Kakourou T, et al. Febrile seizures and primary human herpesvirus 6 infection. Pediatr Neurol. Jan 2010;42(1):28-31. [Medline].

  9. Yao K, Honarmand S, Espinosa A, Akhyani N, Glaser C, Jacobson S. Detection of human herpesvirus-6 in cerebrospinal fluid of patients with encephalitis. Ann Neurol. Mar 2009;65(3):257-67. [Medline].

  10. Gentile I, Talamo M, Borgia G. Is the drug-induced hypersensitivity syndrome (DIHS) due to human herpesvirus 6 infection or to allergy-mediated viral reactivation? Report of a case and literature review. BMC Infect Dis. Mar 6 2010;10:49. [Medline]. [Full Text].

  11. CARI. Donor sepsis. Nephrology. 2005;10(Suppl 4):S129-32.

  12. AAP 2000 Red Book. Human herpesvirus 6 (including roseola) and 7. In: 2000 Red Book: Report of the Committee on Infectious Diseases. 25th ed. Amer Academy of Pediatrics; 2000:322-4.

  13. Ablashi DV, Lusso P, Hung CL, et al. Utilization of human hematopoietic cell lines for the propagation and characterization of HBLV (human herpesvirus 6). Int J Cancer. Nov 15 1988;42(5):787-91. [Medline].

  14. Ablashi DV, Salahuddin SZ, Josephs SF, et al. HBLV (or HHV-6) in human cell lines. Nature. Sep 17-23 1987;329(6136):207. [Medline].

  15. Asano Y, Yoshikawa T, Kajita Y, et al. Fatal encephalitis/encephalopathy in primary human herpesvirus-6 infection. Arch Dis Child. Dec 1992;67(12):1484-5. [Medline].

  16. Asano Y, Yoshikawa T, Suga S, et al. Fatal fulminant hepatitis in an infant with human herpesvirus-6 infection. Lancet. Apr 7 1990;335(8693):862-3. [Medline].

  17. Behrman RE, Kliegman R, Jenson HB. Nelson Textbook of Pediatrics. 16th ed. Philadelphia, PA: WB Saunders and Co; 2000.

  18. Braun DK, Dominguez G, Pellett PE. Human herpesvirus 6. Clin Microbiol Rev. Jul 1997;10(3):521-67. [Medline]. [Full Text].

  19. Dewhurst S, McIntyre K, Schnabel K, Hall CB. Human herpesvirus 6 (HHV-6) variant B accounts for the majority of symptomatic primary HHV-6 infections in a population of U.S. infants. J Clin Microbiol. Feb 1993;31(2):416-8. [Medline]. [Full Text].

  20. Hall CB, Long CE, Schnabel KC, Hall CB. Human herpesvirus-6 infection in children. A prospective study of complications and reactivation. N Engl J Med. Aug 18 1994;331(7):432-8. [Medline].

  21. Harnett GB, Farr TJ, Pietroboni GR, Bucens MR. Frequent shedding of human herpesvirus 6 in saliva. J Med Virol. Feb 1990;30(2):128-30. [Medline].

  22. Huang LM, Lee CY, Lin KH, et al. Human herpesvirus-6 associated with fatal haemophagocytic syndrome. Lancet. Jul 7 1990;336(8706):60-1. [Medline].

  23. Isegawa Y, Ping Z, Nakano K, et al. Human herpesvirus 6 open reading frame U12 encodes a functional beta- chemokine receptor. J Virol. Jul 1998;72(7):6104-12. [Medline].

  24. Kemp CH, Shaw EB, Lackson JR. Studies on the etiology of exanthem subitum (roseola infantum). J Pediatr. 1950;37:561.

  25. Kim JS, Lee KS, Park JH, et al. Detection of human herpesvirus 6 variant A in peripheral blood mononuclear cells from multiple sclerosis patients. Eur Neurol. 2000;43(3):170-3. [Medline].

  26. Knox KK, Harrington DP, Carrigan DR. Fulminant human herpesvirus six encephalitis in a human immunodeficiency virus-infected infant. J Med Virol. Mar 1995;45(3):288-92. [Medline].

  27. Leach CT. Roseola (Human herpesvirus types 6 and 7). In: Behrman RE, Kliegman R, Jenson HB, eds. Nelson Textbook of Pediatrics. WB Saunders and Co; 2000:984-6.

  28. Levy JA, Ferro F, Greenspan D, Lennette ET. Frequent isolation of HHV-6 from saliva and high seroprevalence of the virus in the population. Lancet. May 5 1990;335(8697):1047-50. [Medline].

  29. Mendel I, de Matteis M, Bertin C, et al. Fulminant hepatitis in neonates with human herpesvirus 6 infection. Pediatr Infect Dis J. Nov 1995;14(11):993-7. [Medline].

  30. Portolani M, Cermelli C, Meacci M, et al. Primary infection by HHV-6 variant B associated with a fatal case of hemophagocytic syndrome. New Microbiol. Jan 1997;20(1):7-11. [Medline].

  31. Portolani M, Cermelli C, Moroni A, et al. Human herpesvirus-6 infections in infants admitted to hospital. J Med Virol. Feb 1993;39(2):146-51. [Medline].

  32. Ranger S, Patillaud S, Denis F, et al. Seroepidemiology of human herpesvirus-6 in pregnant women from different parts of the world. J Med Virol. Jul 1991;34(3):194-8. [Medline].

  33. Rotola A, Caselli E, Cassai E, et al. Novel human herpesviruses and multiple sclerosis. J Neurovirol. May 2000;6 Suppl 2:S88-91. [Medline].

  34. Salahuddin SZ, Ablashi DV, Markham PD, et al. Isolation of a new virus, HBLV, in patients with lymphoproliferative disorders. Science. Oct 31 1986;234(4776):596-601. [Medline].

  35. Suga S, Yoshikawa T, Kajita Y, et al. Prospective study of persistence and excretion of human herpesvirus-6 in patients with exanthem subitum and their parents. Pediatrics. Oct 1998;102(4 Pt 1):900-4. [Medline].

  36. van den Berg JS, van Zeijl JH, Rotteveel JJ, et al. Neuroinvasion by human herpesvirus type 7 in a case of exanthem subitum with severe neurologic manifestations. Neurology. Mar 23 1999;52(5):1077-9. [Medline].

  37. Zou P, Isegawa Y, Nakano K, et al. Human herpesvirus 6 open reading frame U83 encodes a functional chemokine. J Virol. Jul 1999;73(7):5926-33. [Medline].

 
Previous
Next
 
A 9-month-old infant boy presented with a 1-day history of high-grade fever and irritability. In the emergency department, the patient had a septic workup including lumbar puncture (adhesive bandage) with normal cerebrospinal fluid analysis results. He was admitted to the hospital.
A 9-month-old infant boy presented with a 1-day history of high-grade fever and irritability. In the emergency department, the patient had a septic workup including lumbar puncture with normal cerebrospinal fluid analysis results. He was admitted to the hospital. High-grade fever abruptly resolved on the third day of hospitalization. Within a few hours, an erythematous, pink papular (roseola), nonpruritic rash appeared, mainly on the trunk.
A 9-month-old infant boy presented with a 1-day history of high-grade fever and irritability. In the emergency department, the patient had septic workup including lumbar puncture with normal cerebrospinal fluid analysis results. He was admitted to the hospital. High-grade fever abruptly resolved on the third day of hospitalization. Within a few hours, an erythematous, pink papular (roseola), nonpruritic rash appeared mainly on the trunk. Patient was playful after supportive therapy. Antibiotics discontinued after 2 days of negative culture. Rash is distributed mainly over the trunk.
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.